Clinical Analysis Of Invasive Fungal Infections In41Patients With Hematologic Malignancies

ObjectiveTo summarized the clinical characteristics, high-risk factors of the41hematologicalmalignancies patients with invasive fungal infections (IFI), and analyzed the therapeuticmanagement and impact factors related to therapy.MethodTo analyze retrospectively the1590cases of patients with hematological malignancieswho were treated at our hospital from the years of2001to2011, which included41patientsaccord with the diagnostic standard of IFI. Collected and summarized the high-risk factorsrelated to the incidence of IFI,and the clinical characteristic, analyzed the efficacies ofantifungal therapy and impact factors related to therapy. The statistics measures Chi-square testand logistic regression were used to analyzed the data by method of SPSS17.0model.RerultThe total incidence of IFI is2.58%(41/1590cases)from the years of2001to2011inour hospital, with an ascending tendency. The majority risk factors related to the IFI includedprolonged neutropenia and mucosal injury. The symptoms and physical signs of IFI had nospecificity. Pulmonary IFI, as one of the most common types, accounted for78.05%(32/41cases)of all IFI patients, CT scan was the important manages be used in the diagnosis ofPulmonary IFI nowadays, the characterristic outcomes included cavity, halo sign, interstitialchanges and nodus near pleura, et al. The comprised cases of proven, probable and possible IFIat rates of9.76％（4/41cases）,12.20％(5/41cases), and78.05％（32/41cases）. There were15episodes of fungi documented by blood or tissue culture or by biopsy, in which the majoritywere Candida species and Aspergillus species at the rate of26.67%(4/15cases) and60.00%(9/15cases).29（70.73%）cases were cured and6(14.63%) death related to IFI of the41patients. As the antifungal agent be used in initial therapy,Voriconazole was more effectivethan fluconazole (63.64%vs.25.93%, P=0.036). The independent impact factors related to therapy included whether the hematologic malignancies were complete remission (CR) or no,if thepatients accepted the HSCT or no. The antifungal agents were safe, only7patients havedslight side-effect.ConclusionProfound neutropenia and the hematologic malignancies no remission were themajority risk factors related to the incidence in the patients with hematologic malignanciesdiseases. Voriconazole was more effective than fluconazole in the initial treatment. Theindependent impact factors related to therapy included whether the hematologic malignancieswere complete remission (CR) or no,if the patients accepted the HSCT or no.